Pediatric chiropractic care, and when the answer is your pediatrician

We see kids at our Clarksville office from newborns to age 18, and this page is about muscle and joint complaints. Parents who call about seeing a chiropractor for their kids are usually asking two things at once: could it help with something specific, and is it a reasonable thing to do for a child at all? We'll give you a straight answer to both, and the second one matters more.

Your pediatrician is still your child's first call. Growth, development, illness, feeding, sleep and behavior all belong with them, and we'll tell you plainly when something falls outside what we treat.

Who we see, and what "pediatric chiropractor" means here

Treatment is always based on the child's age, size, condition and individual needs. It isn't adult care scaled down to a smaller body.

None of our doctors currently holds a pediatric chiropractic certification or specialty license. We say that plainly because "pediatric chiropractor" gets used so widely that it can sound like a credential, and on this site it isn't one. Here it simply means that we see kids, and the rest of this page is what that looks like in our office.

What is chiropractic care for kids used for?

Manual care for children is used for musculoskeletal complaints: back and neck pain, sports injuries, movement restriction after a fall, and postural discomfort in older kids and teenagers.

It isn't a treatment for the things it's often marketed for. You'll see claims that spinal care in children improves general health, immune function, brain development, behavior, sleep, feeding, or the course of a childhood illness. The evidence behind those claims isn't good enough to justify making them, and we don't make them.

You'll also run into the idea that a child's spine can be quietly out of alignment and causing harm nobody has noticed. There's no good evidence for it, and it isn't a reason to start care.

What does chiropractic care for an infant involve?

Babies get their own section because research on older kids or adults can't establish the benefits or risks for a baby.

Here's the part we want you to hear first. A 2024 international physiotherapy position statement recommends against spinal manipulation or mobilization in infants, and against using either for non-musculoskeletal conditions in children. It also recommends against cervical and lumbar spinal manipulation in children. Those are real limits, and they're worth raising with your pediatrician. The research notes further down this page cover the statement's scope.

With an infant, we may use very gentle, low-force techniques, such as an Activator, and we adapt the approach to the baby's age, size and individual needs. A gentler technique isn't evidence of safety or benefit, so the exact technique and what the evidence and risks look like at your baby's age are worth going over, with us and with your pediatrician, before you decide anything.

The first conversation about a baby's concern belongs with the pediatrician: does anything need doing at all, and what would simply watching involve? Research on a teenager with a sports injury can't answer those questions for an infant.

What the research shows about colic

Parents do ask us about colic, so the evidence deserves a clear explanation.

What colic is. Colic is the name for a pattern of long crying spells in a baby who's otherwise healthy, and it commonly eases as the baby grows. Crying can also come with illness, though, so the pediatrician should check your baby before anyone calls it colic, and the American Academy of Pediatrics sets out the crying pattern and when to call your pediatrician.

What the evidence shows. A Cochrane review of manipulative therapies for infant colic found the trials were small and couldn't show benefit or safety with any confidence. When the reviewers looked only at studies where parents didn't know if their baby had been treated, manipulation showed no improvement. Only one of the included studies looked at safety at all. A baby who's better after a visit doesn't show that the visit was the reason.

So we don't tell parents we treat colic. Parents do bring babies here for it, and we'll examine a baby and tell you what we find. What we won't do is take something that usually gets better on its own and sell you a course of care on the idea that we're the reason it did.

When crying needs medical care. Call 911 or go to an emergency room if your baby is hard to wake, is having trouble breathing, or seems seriously unwell. A baby under three months with a temperature of 100.4°F (38°C) or higher also needs immediate medical assessment, and that isn't something to hold for a chiropractic appointment. These are among the urgent warning signs the NHS lists for babies and young children. Other changes, like poor feeding, repeated vomiting, blood in the stool, or worries about growth, call for a prompt call to the pediatrician before anyone assumes it's colic.

Common muscle and joint problems in kids and teenagers

• Sports injuries and overuse. Growing athletes get the same strains and overload problems adults do, with one big difference: their growth plates are still open, and that changes what some injuries mean and how they're managed. Our guide for athletes has more on sports injuries.
• Back and neck pain in adolescents. The details that help at an exam are plain ones: when it hurts, what makes it better or worse, and how much it's getting in the way of sleep, school or sport. They describe the pain without guessing at its cause.
• Discomfort while carrying a bag or sitting at a desk. Tweaking a bag for comfort is fine to talk about, and our backpack guide has the practical checks. But a systematic review of schoolbag research found no convincing evidence that bag weight, design or carrying method increases the risk of back pain.
• Falls and awkward landings, which are part of childhood and now and then produce something that doesn't settle on its own.

Back pain in a young child is different from back pain in a teenager. Persistent back pain in a child who hasn't reached adolescence is less common, and it's a reason for a medical assessment, not an assumption that it's a muscle or joint problem.

When should a child see their pediatrician or go to the ER instead?

Some signs are warnings of a spinal nerve emergency and need an emergency room right away: new difficulty passing urine, loss of bladder or bowel control, numbness around the saddle area, or severe or worsening weakness in both legs. They're the same emergency signs the NHS lists for sciatica. Please don't wait for an appointment with us or with the pediatrician.

These need prompt medical assessment through your child's pediatrician or urgent care:

• Back pain with fever, or with unexplained weight loss
• Back pain that is persistent, worsening, or lasting more than a few weeks, at any age, and any pain that wakes a child at night
• Pain after significant trauma such as a fall from height or a collision
• New weakness or numbness that does not fit the emergency signs above
• Any change in how a child is walking that did not follow an obvious injury
• Anything you are unsure about, or that does not fit an obvious knock or strain

Is chiropractic care safe for children, and what are the alternatives?

We can't give you a blanket yes. The published research can't put a reliable number on the risk of harm in children, and the 2024 position statement recommends against some techniques at some ages.

The risk, realistically. A systematic scoping review of pediatric spinal manipulation and mobilization found that harms were reported inconsistently. Some individual studies reported benefits, but taken together the review didn't support these treatments for the pediatric conditions it looked at. The published reports can't give a reliable rate of adverse events. The 2024 position statement above draws different lines by age, spinal region and condition, so it can't be boiled down to a blanket reassurance that care is safe for children, and we won't tell you that it is.

Other options, and what they offer. Depending on the problem, watching and waiting, a change in activity, pediatric physical therapy or sports medicine may be the right fit, and your pediatrician is the right person to sort out which. Watching and waiting spares a child treatment for a problem that may settle with time, and a pediatric physical therapist works with a child on exercise and movement. The choice depends on your child's age, symptoms and assessment. For an infant, once medical causes of the concern have been looked at, the first question is simply: does anything need doing at all?

Deciding on care for your baby or child

We'd encourage you to talk the proposed care over with your child's pediatrician before it starts. The National Institutes of Health's complementary health center, NCCIH, notes that studies of the safety of mind and body practices specifically in children are limited, and it recommends telling your child's health care provider about any complementary approach you're considering.

Before you say yes to care for a child, you should be able to answer four plain questions. What exactly is being treated? What does the research show for a child that age? What are the risks of the technique? And what would be a reason to stop? Watching and waiting, or pediatric physical therapy, belong in the same comparison, because they have something to offer too.

With a crying baby, feeding, growth and illness come first, and that's the pediatrician's job to check: the AAP recommends talking about crying with your pediatrician to rule out a medical explanation. A birth story or whatever is worrying you is a starting point for talking it through, but it never stands in for an individual assessment of your child.

What happens at a child's first visit?

A first visit includes a history and an exam. For a child, the history covers what's bothering them, the activities that bring it on, and anything the pediatrician has already looked at, so it helps to bring those details and any notes from earlier medical visits. How a parent or caregiver takes part, and what the exam involves at your child's age, are fair questions to ask when you call.

We'll tell you what we find, including when it isn't something we treat. If what's going on belongs with your child's pediatrician, we'll say so and point you there.

If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider. And if your teenager's sore back or neck started at practice or in a game, that's the story we'll start with.